Guidanced for you who need to start downregulation before your stimulation
Dear
You are now ready to start your downregulation, which is a pre-treatment for your fertility treatment.
You must begin with the medication for downregulation:
__ Synarela nasal spray, 1 puff x 3 daily, from the __________ to the __________
__ Gonapeptyl 0.1 mg (1 syringe) x 1 daily at 22 p.m.,
from the __________ to the __________
__ Other medications: __________________________________________
You must attend a new control scan:
__________ day on the __________ at __________
Synarela:
Synarela is absorbed through the mucous membrane of the nose and throat. A spray in one nostril 3 times a day is needed. Change nostril every other time to reduce discomfort. If you have a cold, you must clear your nose before and after the spray if needed.
Synarela must be stored at room temperature below 25 degrees.
Gonapeptyl:
Gonapeptyl is a disposable syringe that you inject in your stomach every evening at approx. 22 p.m. The syringe is easy to inject but you must expect some discomfort and bruising at the injection site.
Gonapeptyl must be stored at 2-8 degrees.
Effect of downregulation:
The downregulation treatment inhibits your own production of the follicle stimulating hormone, FSH, and the luteinizing hormone, LH, which induces ovulation. These hormones are normally released from the pituitary gland in the brain and contributes to egg maturation and ovulation in the natural cycle. Downregulation is most often explained as artificial menopause, which is used to prevent ovulation in the stimulation period.
Side effects:
During the downregulation period, you may experience side effects, typically in the form of headaches, hot flashes and mood swings. Too reduce headaches, you may take 1 gram of paracetamol.
Downregulation period:
The downregulation period typically lasts 14 days. Most will have their period after approx. 1 week into the treatment. The bleeding may be delayed but this does not show to have any implication. Thus, you may not have had your period on the day of your scheduled control scan.
Control scan:
On this visit, we check whether you are properly downregulated. We measure the thickness of your endometrial lining in the uterus, which must be properly rejected and thin after menstruation. Hereafter, we plan your treatment with FSH to stimulate your follicles to grow. The downregulation treatment continues until you have to take the ovulation trigger.
Useful websites and apps:
www.medicininstruktion.dk
On this website you will find instructions on how to inject yourself.
Under ‘Behandlingsområder’ choose ‘Fertilitet’ and you will find help for:
Bemfola, Fyremadel, Gonal-f, Menopur, Ovitrelle, Pergoveris and Rekovelle (Ganirelix, Gonapeptyl has the same instruction as Fyremadel).
MinLæge or MinSundhed (App)
Here you are always able to see which active prescriptions you have. It is recommended to check this before you leave the department.
If you need new prescriptions, you must talk to the doctor.
Apoteket (App)
Here you can choose your preferred pharmacy and then you can check if that pharmacy has the medicine in stock that you need. You can also find a medication reminder where you can type your type of medication and the time and then set an alarm for this.
You are welcome to cantact us if any questions might occur.
With best regards
The Fertility Department, Rigshospitalet